Doctor weighs in on cough meds debate

September 16, 2010

If the Food and Drug Administration takes the advice of medical experts about keeping cough medications over-the-counter, pediatrician Dr. Zak Zarbock hopes the agency will at least consider additional regulations to help keep children safe.

Zarbock, who spoke to the panel as an expert source on the dangers of the cough suppressant detromethorphan, said he would like to see the FDA standardize the over-the-counter medications' labels to help parents dose their children properly.

"Right now some labels say (if your child is) 4-6, ask a doctor. Some say no one under 6 (should take it)," he said in a phone interview Wednesday. It's confusing for parents, who will sometimes just give their best guess as to what dose to give their children, especially if they are dealing with a coughing child in the middle of the night.

He also is an advocate of raising the minimum recommended age for the product to age 6.

A father of four boys in Salt Lake City, Utah, Zarbock received his medical training at The Ohio State University. He said studies have proven dextromethorphan, found in products such as Dimetapp and Robitussin, is not effective on coughs, and that more and more children ages 12-17 are using it to get high.

"They classify it as a mildly addictive substance. ... They talked about it (at the meeting Tuesday) as somewhat of a gateway drug."

He recommends retail outlets shelve the products in highly visible, higher-trafficked areas to deter theft by teens seeking to get high.

Zarbock noted if parents give their children dextromethorphan as directed by a doctor or by the package directions, it will not harm their children or "create a community of drug abusers."

"If used appropriately, as the dose is recommend, it's safe - not effective - but safe."

He cited a 2007 Penn State University study that found buckwheat honey outperformed both dextromethorphan and a placebo; the latter two had similar results.

He presented that and other data to the advisory panel on Tuesday.

"Many of them were well aware that dextromethorphan is not proven to work in children."

Based on the research, Zarbock developed ZarBees Children's Cough Syrup, which contains honey, vitamin A, zinc and natural flavors, as an alternative to dextromethorphan-based medicines. It is recommended for children and adults older than 12 months.